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4th Annual Youth Engagement Talent Show Referral Form
Pre-Audition Instructions:
Contact any Danville Police Department Officer. This can be on your street, at your school, or you can come to Police Headquarters (1 Community Way, Danville, VA 24541)
Perform a 10 second to 15 second sample of your talent or act
Please complete this form with your talent details and reach out to Corporal Sylvia Brooks for final confirmation. Her information is 434-797-8898, ext. 4.
The officer has to approve the audition and either the officer or participant can complete this form
Requirements for Pre-Audition:
"G" Rated Performances ONLY
12th Grade to Pre-School Ages ONLY
10-15 second snippet of actual performance
DEADLINE TO AUDITION OCTOBER 31ST
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Email
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Your email
First Name of Participant
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Your answer
Last Name of Participant
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Your answer
Participant's Street Address (123 Main Street)
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Your answer
Participant's City
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Your answer
Participant's State
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Your answer
Participant's Zip Code
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Your answer
Participant's Phone Number (434-111-1234)
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Your answer
Participant's Email Address
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Your answer
Participant's Age
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Your answer
Participant's Current Grade
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Your answer
Parent or Guardian's First Name
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Your answer
Parent or Guardian's Last Name
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Your answer
Parent or Guardian's Street Address (123 Main Street)
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Your answer
Parent or Guardian's City
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Your answer
Parent or Guardian's State
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Your answer
Parent of Guardian's Zip Code
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Your answer
Parent or Guardian's Phone Number (434-111-1234)
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Your answer
Parent or Guardian's Email Address
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Your answer
Referring Officer (who you auditioned in front of)
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Your answer
Date of Audition
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MM
/
DD
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YYYY
Time of Audition
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Time
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AM
PM
Talent/Act Description (EX: sample song, length of act)
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Your answer
A copy of your responses will be emailed to the address you provided.
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